Success of Brain Surgery for Severe Epilepsy

Success of Brain Surgery for Severe Epilepsy

The new study that examined 143 of these patients two years after their operations not only shows the promise of this type of neurosurgery at treating severe epilepsy, it also highlights how research into brain imaging may help to further improve results for people who have such operations.

"Surgery can be a powerful way to stop this disorder in its tracks," said UCSF Neurosurgeon Edward Chang, who led study. ”Many of these people were living 10, 15 or 20 years with very severe and dangerous seizures."

The success of the surgery, added Chang, was directly related to the accuracy with which the medical team could map the brain, identify the exact pieces of tissue responsible for an individual's seizures and ultimately remove them. "We need to continue to focus on developing new methods to figure out and pinpoint where the seizures are coming from," said Chang.

For many people with epilepsy, seizures are triggered by physical malformations in their brains that formed during early development. Powerful anticonvulsant drugs help many of them overcome their seizures, but a subset of people with epilepsy do not respond to the drugs. Some suffer only the occasional seizure, but others with more severe cases of epilepsy may suffer from dozens of seizures daily.

For those with such severe, untreatable epilepsy, brain surgery can be the last and best hope, aiming to remove the problematic pieces of brain tissue – which may be as small as an acorn or as large as half the brain.

As the new study has highlighted, when the surgery works it can completely cure the seizures overnight. But a challenge remains because many malformations that cause the seizures are invisible to most forms of imaging.

The better doctors can map the brain and identify the source of the seizures, Chang said, the greater will be the impact of the surgery.